‘Community Transmission’: Is India Testing Enough People?

The experts have persistently expressed their dismay over testing numbers, doubting whether India is testing enough people.

The conversation around Covid-19 testing has an extremely important term that defines how bad the situation is in your country or state- ‘Community Transmission’.

What is Community Transmission?

Community transmission is a stage in spread of the disease when a person or group of persons gets infected with the disease, but the source of their infection is unknown. Simply put, you don’t know where they got infected and who the source of infection is. They might have got infected in their office space or on a bus, you can’t tell.

Almost all countries are following the same procedures in the wake of the Coronavirus outbreak. If a patient tests positive of Covid-19, it’s checked whether he/she has a travel history to any other country with outbreak, or if he/she has come in contact with an already infected person they are aware of.

But when a large number of people test positive without having any of the two aforementioned scenarios, it is considered as community transmission. The source of transmission to these people is unknown.

America had reported it’s the first case of community transmission last month. Since then, many other states have reported the same. UK, Australia, and Indonesia have also confirmed cases of community transmission.

Has there Been Community Transmission in India?

Only someone who has symptoms such as fever, coughing, and breathlessness can get tested in India for Covid-19. But here is a twist. Even if you have a symptom, you must have a travel history to the countries with outbreak of virus or you should have come in contact with an already infected person.

There have been a few cases where both these conditions were not satisfied despite having the symptoms.

A few have said that despite having the symptoms they have not been tested for the coronavirus since they neither have a travel history nor have they knowingly come in contact with an already infected person. Many said the doctors continue to prescribe paracetamol and other medicines on flue since the hospitals are crowded and not everyone can get tested for the virus.

As numbers continue to increase every passing day, the experts have persistently expressed their dismay over testing numbers, doubting whether India is testing enough people.

What are the stages of transmission?

In the first case, the country has imported cases- those who have come from a country that has already seen a widespread outbreak of the coronavirus. The second stage is when you have cases of people coming in contact with imported cases and getting infected. The third stage, Community Transmission, is when you do not know a source of infection. The fourth stage is an epidemic when the virus spreads beyond normal expectancy based on criteria set by the World Health Organisation (WHO) for that disease. When it spreads across the world, it is a pandemic, which Covid-19 has already been esteemed by.

Restrictive Nature of Testing

The Indian Council of Medical Research (ICMR) press release on 19th March said, it tested 826 people with symptoms randomly, who had no travel history or direct contact with an imported case. The tests were negative. In it’s earlier release on 18th, the ICMR had said that after observing the 826 cases, they are assured that there has been no community transmission yet.

Experts say, in a country with ample size and population like India, 826 is a very small sample to conclude that there has been no community transmission.

Till now India has tested around 13,000 people- with around 9.2 tests per million. South Korea, which has been applauded for containing the virus very effectively, has tested 295,647 people until March 18, 2020- around 5,729.6 tests per million. Many countries have set up targets of testing million and two million people as fast as they could do. Some countries have made the tests free allowing maximum people with symptoms to be tested.

World Health Organization Director-General Tedros Adhanom Ghebreyesus gave a very important message to all the countries on 16th Match- “Test, test, test”.

Update- The Indian Council of Medical Research (ICMR) has said on Saturday that they will be testing all symptomatic patients with exceptions. Symptomatic contacts of laboratory-confirmed cases, symptomatic health care workers, and all hospitalized patients with Severe Acute Respiratory Illness (fever AND cough and/or shortness of breath) will be tested as well, informed ICMR.